CGSL COVID-19 Screening

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EACH PLAYER MUST complete the screening form prior to their game. A form MUST be completed each day the player participates in a game (eg. each weekend of play requires a new form to be submitted). If you answer YES to ANY of the questions below, please STAY HOME!

Game Date *

YYYY

Full Name (as registered with CGSL) *

Team Name *

Does you or anyone at your location have any of the following symptoms: fever or chills, new or onset cough, difficulty breathing, shortness of breath, sore throat or difficulty swallowing, decease or loss of taste and smell, pink eye, headache, running, stuffy or congested nose, digestive issues (nausea/vomiting/diarrhea/stomach pain), muscle aches/joint pain, extreme tiredness and/or falling down? *

Yes

Have you or anyone at your location travelled outside Canada in the last 14 days? *

Yes

Has a doctor, health care provided, or public health unit told you that you should currently be isolating (staying home)? *

Yes

Have you or has anyone at your location tested positive or have had close contact with a confirmed or probable case of COVID-19? *

Yes

If you have a government approved exception and have answered YES to any of the above questions, please indicate below how you are still in compliance, otherwise, please STAY HOME.

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